Transcranial Brain Stimulation Research Articles

Thermovision: a new diagnostic method for orofacial pain?

BackgroundInfrared thermography can be used to obtain more complete information about a patient’s condition. The method can be used in various medical applications for monitoring acute and chronic orofacial pain syndrome. With this diagnostic method, thermal differences in the examined region are usually compared to the same reference region on the opposite side of the body.MethodsInfrared quantitative thermography is a non-invasive method for contactless monitoring of dynamic thermal fields on a surface, or in this case, the human body. This method is based on detection of infrared radiation, which is naturally emitted from the surface of the body. In a pilot project with a patient having orofacial pain, changes before and after repetitive transcranial magnetic brain stimulation treatment were assessed.ResultsFirst-day measurements found significantly higher maximum, minimum, and average temperatures, before and after therapy, in the area where the patient subjectively reported pain. The fifth and final measurements, before and after therapy, found only a slight elevation of the maximum temperature of the assessed regions, relative to the same regions on the opposite side of the face.ConclusionDuring the measurements on the fifth day, a thermal difference greater than 0.4°C was only observed relative to the minimum temperatures associated with the regions of self-reported pain before and after therapy. For validation of the effects, this method will need to be tested using a randomized, double-blind study with a larger number of patients.

No Modulatory Effects when Stimulating the Right Inferior Frontal Gyrus with Continuous 6 Hz tACS and tRNS on Response Inhibition: A Behavioral Study.

Response inhibition is the cognitive process required to cancel an intended action. During that process, a “go” reaction is intercepted particularly by the right inferior frontal gyrus (rIFG) and presupplementary motor area (pre-SMA). After the commission of inhibition errors, theta activity (4–8 Hz) is related to the adaption processes. In this study, we intend to examine whether the boosting of theta activity by electrical stimulation over rIFG reduces the number of errors and the reaction times in a response inhibition task (Go/NoGo paradigm) during and after stimulation. 23 healthy right-handed adults participated in the study. In three separate sessions, theta tACS at 6 Hz, transcranial random noise (tRNS) as a second stimulation condition, and sham stimulation were applied for 20 minutes. Based on behavioral data, this study could not show any effects of 6 Hz tACS as well as full spectrum tRNS on response inhibition in any of the conditions. Since many findings support the relevance of the rIFG for response inhibition, this could mean that 6 Hz activity is not important for response inhibition in that structure. Reasons for our null findings could also lie in the stimulation parameters, such as the electrode montage or the stimulation frequency, which are discussed in this article in more detail. Sharing negative findings will have (1) positive impact on future research questions and study design and will improve (2) knowledge acquisition of noninvasive transcranial brain stimulation techniques.

Les innovations thérapeutiques en alcoologie

Psychosocial support remains the key element of treatment of alcohol-dependent patients in order to either decrease or cease their alcohol consumption. DrugsTwo drugs can now be used to reduce alcohol consumption: nalmefene and baclofen in the context of a “temporary use recommendation”. Currently available studies have shown weak to moderate effect sizes in this indication, but better results have been reported in populations confined to heavy drinkers. Four molecules are available to help patients maintain abstinence: acamprosate, naltrexone, disulfiram and baclofen. Effect sizes calculated by various meta-analyses are also low to moderate. Disulfiram appears to be more effective when the patient has understood its mechanism action and when it is used under supervision. However, the use of disulfiram is limited by the risk of rare, but potentially serious adverse effects. Identification of patient subgroups obtaining better responses to certain drugs constitutes a major research challenge, but only a few criteria have been defined to date. However, regardless of the drug considered, heavy drinking and difficulty to maintain abstinence significantly improve the effect size of the drug. After an initially promising period, especially concerning polymorphism of the OPMR1 gene coding for the morphine μ receptor, identification of genetic markers has not yet resulted in any clinical applications. Promising molecules currently under evaluation include sodium oxybate and topiramate. Among non-pharmacological treatmentsInteresting results have been demonstrated with acceptance and commitment therapy (mindfulness-based cognitive therapy). Studies have also been conducted on cognitive disorders that constitute risk factors for relapse and that limit the efficacy of treatment. The elaboration of cognitive remediation therapy programmes is an important objective for the future. Magnetic or continuous current transcranial brain stimulation methods also open up interesting perspectives, but further studies are necessary to define the place of these treatments in the management of addictive behaviours. PerspectivesFinally, the development of e-health opens up particularly encouraging perspectives to provide patients with information, to help them evaluate and monitor their consumption, to propose assistance and responses in high-risk settings or relapse or to use various therapeutic methods integrated in smartphone applications.

Does transcranial direct current stimulation to the prefrontal cortex affect social behavior? A meta-analysis.

This meta-analysis (k = 48, N = 2196) examined the effect of transcranial direct current brain stimulation (tDCS) applied to the prefrontal cortex on a variety of social behaviors, including aggression, overeating, impulsivity, bias, honesty, and risk-taking. tDCS showed an overall significant effect on reducing undesirable behaviors, with an average effect size of d = −0.20. tDCS was most effective at reducing risk-taking behavior, bias, and overeating. tDCS did not affect aggression, impulsivity, or dishonesty. We examined moderators such as brain region of interest, online vs offline stimulation, within- vs between-subjects designs, dose, and duration, but none showed significant interactions. We also tested for potential publication bias using two different tools, which indicated signs of publication bias in the literature. After correcting for potential publication bias, the effect of tDCS was still significant, but the size was reduced (d = −0.10). These findings suggest the presence of tDCS studies with null findings outside of the published literature. Taken together, these results suggest that although tDCS can reduce undesirable behaviors, researchers should consider the types of behaviors they measure and use strategies to ensure sufficient power to detect a possible effect of tDCS on social behavior.

FS: Towards efficient and specific transcranial brain stimulation - novel biophysical modeling techniques

FS: Towards efficient and specific transcranial brain stimulation - novel biophysical modeling techniques

Towards individualized psychiatric practice: The legacy of neurotherapeutics

In 1997, Freeman Dyson postulated two categories of scientific revolution in his book Imagined Worlds . One kind is a concept-driven revolution, allowing us to explain old things in ways; another kind is tool-driven revolution, allowing us to discover new things that have to be explained. Twenty years later, this perspective still sheds light on the emerging therapeutics in clinical practice. According to the annual report of the American Psychological Association (APA), prevalence of brain disorders is expected to rise tremendously over the coming decades. Taking dementia as an example, with rapid population aging in China, Alzheimers Disease (AD) is expected to have profound impacts on the individuals and society. At present, there are no effective pharmacological treatments to halt or slow the progression of AD. Recent evidence found that non-pharmacological interventions, such as transcranial brain stimulation, are able to improve the cognitive functions and alleviate the psychiatric symptoms. However, given the limited studies, less is known about the underlying mechanisms and the potential tailored treatment with individualized features considered. From the perspective of bioenergetics, brain disorders are due to the disturbance of metabolism or energy, such as entropy. One of the most profound links between metabolism and brain disorders is the dysfunction of mitochondria. Given the responsibility in producing ATP for energy, mitochondria use electrons and protons from molecular oxygen to reduce water and generate proton-motive force to produce ATP from ADP. Because the functioning of our brains only relies on the ATP mitochondria produced, thus when this process is impaired, a variety of brain disorders can occur. From the perspective of physics, four types of energy, including magnetic, electricity, ultrasound and light, can be transformed to the cutting-edge stimulation technologies for exploring brain functions and enhancing the non-pharma- ceutical therapeutics for brain disorders. In this review, we summarized the recent progress of the modality-driven brain stimulations and the state-of-art utility in psychiatric practice. The main interest will focus on the clinical applications of transcranial magnetic stimulation, transcranial electrical stimulation, transcranial focused ultrasound stimulation, transcranial infrared laser stimulation and deep brain stimulation. Except for the empirical evidence, we will also point out the major limitations in the current brain stimulation studies. The framework comprises three innovative points: (1) Heterogeneity: Due to the heterogeneity within clinical population, causal inference with observational data in medical science is nearly impossible without strong assumptions. (2) Lack of key parameters: Scalp-to-cortex distance (SCD), as one of the most important and fundamental parameters of brain imaging and stimulation, has been highlighted in the newly updated guidelines. (3) Monitoring and reporting of the side effects induced by brain stimulation: several reports have mentioned the skin burns, pain and headache during the treatment of brain stimulation. However, we still have no standardized protocol to monitor and record the potential side effects. Taken together, this review introduces an in-depth understanding of the mechanisms of brain stimulation and its applications and future directions in individualized psychiatric practice.

Speech Registration in Symptomatic Memory Impairment.

Background: An inability to recall recent conversations often indicates impaired episodic memory retrieval. It may also reflect a failure of attentive registration of spoken sentences which leads to unsuccessful memory encoding. The hypothesis was that patients complaining of impaired memory would demonstrate impaired function of “multiple demand” (MD) brain regions, whose activation profile generalizes across cognitive domains, during speech registration in naturalistic listening conditions.Methods: Using functional MRI, brain activity was measured in 22 normal participants and 31 patients complaining of memory impairment, 21 of whom had possible or probable Alzheimer’s disease (AD). Participants heard a target speaker, either speaking alone or in the presence of distracting background speech, followed by a question to determine if the target speech had been registered.Results: Patients performed poorly at registering verbal information, which correlated with their scores on a screening test of cognitive impairment. Speech registration was associated with widely distributed activity in both auditory cortex and in MD cortex. Additional regions were most active when the target speech had to be separated from background speech. Activity in midline and lateral frontal MD cortex was reduced in the patients. A central cholinesterase inhibitor to increase brain acetylcholine levels in half the patients was not observed to alter brain activity or improve task performance at a second fMRI scan performed 6–11 weeks later. However, individual performances spontaneously fluctuated between the two scanning sessions, and these performance differences correlated with activity within a right hemisphere fronto-temporal system previously associated with sustained auditory attention.Conclusions: Midline and lateralized frontal regions that are engaged in task-dependent attention to, and registration of, verbal information are potential targets for transcranial brain stimulation to improve speech registration in neurodegenerative conditions.

Social decision making in autism: On the impact of mirror neurons, motor control, and imitative behaviors.

SummaryThe Mirror Neuron System (MNS) plays a crucial role in action perception and imitative behavior, which is suggested to be impaired in Autism Spectrum Disorders (ASDs). In this review, we discuss the plausibility and empirical evidence of a neural interaction between the MNS, action perception, empathy, imitative behavior, and their impact on social decision making in ASDs. To date, there is no consensus regarding a particular theory in ASDs and its underlying mechanisms. Some theories have completely focused on social difficulties, others have emphasized sensory aspects. Based on the current studies, we suggest a multilayer neural network model including the MNS on a first layer and transforming this information to a higher layer network responsible for reasoning. Future studies with ASD participants combining behavioral tasks with neuroimaging methods and transcranial brain stimulation as well as computational modeling can help validate and complement this suggested model. Moreover, we propose applying the behavioral paradigms, and the neurophysiological markers mentioned in this review article for evaluating psychiatric treatment approaches in ASDs. The investigation of modulating effects of different treatment approaches on the neurophysiological markers of the MNS can help find specific subgroups of ASDs patients and support tailored psychiatric interventions.

Why You Should Report Bayes Factors in Your Transcranial Brain Stimulation Studies.

Why You Should Report Bayes Factors in Your Transcranial Brain Stimulation Studies.

Cost-effectiveness of preoperative motor mapping with navigated transcranial magnetic brain stimulation in patients with high-grade glioma.

OBJECTIVE Navigated transcranial magnetic stimulation (nTMS) is used to identify the motor cortex prior to surgery. Yet, there has, until now, been no published evidence on the economic impact of nTMS. This study aims to analyze the cost-effectiveness of nTMS, evaluating the incremental costs of nTMS motor mapping per additional quality-adjusted life year (QALY). By doing so, this study also provides a model allowing for future analysis of general cost-effectiveness of new neuro-oncological treatment options. METHODS The authors used a microsimulation model based on their cohort population sampled for 1000 patients over the time horizon of 2 years. A health care provider perspective was used to assemble direct costs of total treatment. Transition probabilities and health utilities were based on published literature. Effects were stated in QALYs and established for health state subgroups. RESULTS In all scenarios, preoperative mapping was considered cost-effective with a willingness-to-pay threshold < 3*per capita GDP (gross domestic product). The incremental cost-effectiveness ratio (ICER) of nTMS versus no nTMS was 45,086 Euros/QALY. Sensitivity analyses showed robust results with a high impact of total treatment costs and utility of progression-free survival. Comparing the incremental costs caused by nTMS implementation only, the ICER decreased to 1967 Euros/QALY. CONCLUSIONS Motor mapping prior to surgery provides a cost-effective tool to improve the clinical outcome and overall survival of high-grade glioma patients in a resource-limited setting. Moreover, the model used in this study can be used in the future to analyze new treatment options in neuro-oncology in terms of their general cost-effectiveness.

Feedforward neural control of toe walking in humans.

Activation of ankle muscles at ground contact during toe walking is unaltered when sensory feedback is blocked or the ground is suddenly dropped. Responses in the soleus muscle to transcranial magnetic stimulation, but not peripheral nerve stimulation, are facilitated at ground contact during toe walking. We argue that toe walking is supported by feedforward control at ground contact. Toe walking requires careful control of the ankle muscles in order to absorb the impact of ground contact and maintain a stable position of the joint. The present study aimed to clarify the peripheral and central neural mechanisms involved. Fifteen healthy adults walked on a treadmill (3.0kmh-1 ). Tibialis anterior (TA) and soleus (Sol) EMG, knee and ankle joint angles, and gastrocnemius-soleus muscle fascicle lengths were recorded. Peripheral and central contributions to the EMG activity were assessed by afferent blockade, H-reflex testing, transcranial magnetic brain stimulation (TMS) and sudden unloading of the planter flexor muscle-tendon complex. Sol EMG activity started prior to ground contact and remained high throughout stance. TA EMG activity, which is normally seen around ground contact during heel strike walking, was absent. Although stretch of the Achilles tendon-muscle complex was observed after ground contact, this was not associated with lengthening of the ankle plantar flexor muscle fascicles. Sol EMG around ground contact was not affected by ischaemic blockade of large-diameter sensory afferents, or the sudden removal of ground support shortly after toe contact. Soleus motor-evoked potentials elicited by TMS were facilitated immediately after ground contact, whereas Sol H-reflexes were not. These findings indicate that at the crucial time of ankle stabilization following ground contact, toe walking is governed by centrally mediated motor drive rather than sensory driven reflex mechanisms. These findings have implications for our understanding of the control of human gait during voluntary toe walking.

Modulating fluid intelligence performance through combined cognitive training and brain stimulation

It is debated whether cognitive training of specific executive functions leads to far transfer effects, such as improvements in fluid intelligence (Gf). Within this context, transcranial direct current stimulation and recently also novel protocols such as transcranial random noise and alternating current stimulation are being investigated with regards to their ability to enhance cognitive training outcomes.We compared the effects of four different transcranial electrical brain stimulation protocols in combination with nine daily computerized training sessions on Gf.82 participants were randomly assigned to receive transcranial direct current stimulation (tDCS), random noise stimulation (tRNS), multifocal alternating current stimulation at 40 Hz (mftACS), or multifocal tDCS (mftDCS) in combination with an adaptive and synergistic executive function (EF) training, or to a no-contact control group. EF training consisted of gamified tasks drawing on isolated as well as integrated executive functions (working memory, inhibition, cognitive flexibility). Transfer was assessed with a combined measure of Gf including three established tests (Bochumer Matrizentest - BOMAT, Raven's Advanced Progressive Matrices - RAPM, and Sandia Matrices). We found significant improvements in Gf for the tDCS, mftDCS, and tRNS groups when compared with the no-contact group. In contrast, the mftACS group did not improve significantly and showed a similar pattern as the no-contact group. Mediation analyses indicated that the improvement in Gf was mediated through game progression in the mftDCS and tRNS group. Electrical brain stimulation in combination with sustained EF training can lead to transfer effects in Gf, which are mediated by training progression.

Automatic skull segmentation from MR images for realistic volume conductor models of the head: Assessment of the state-of-the-art

Anatomically realistic volume conductor models of the human head are important for accurate forward modeling of the electric field during transcranial brain stimulation (TBS), electro- (EEG) and magnetoencephalography (MEG). In particular, the skull compartment exerts a strong influence on the field distribution due to its low conductivity, suggesting the need to represent its geometry accurately. However, automatic skull reconstruction from structural magnetic resonance (MR) images is difficult, as compact bone has a very low signal in magnetic resonance imaging (MRI). Here, we evaluate three methods for skull segmentation, namely FSL BET2, the unified segmentation routine of SPM12 with extended spatial tissue priors, and the skullfinder tool of BrainSuite. To our knowledge, this study is the first to rigorously assess the accuracy of these state-of-the-art tools by comparison with CT-based skull segmentations on a group of ten subjects. We demonstrate several key factors that improve the segmentation quality, including the use of multi-contrast MRI data, the optimization of the MR sequences and the adaptation of the parameters of the segmentation methods. We conclude that FSL and SPM12 achieve better skull segmentations than BrainSuite. The former methods obtain reasonable results for the upper part of the skull when a combination of T1- and T2-weighted images is used as input. The SPM12-based results can be improved slightly further by means of simple morphological operations to fix local defects. In contrast to FSL BET2, the SPM12-based segmentation with extended spatial tissue priors and the BrainSuite-based segmentation provide coarse reconstructions of the vertebrae, enabling the construction of volume conductor models that include the neck. We exemplarily demonstrate that the extended models enable a more accurate estimation of the electric field distribution during transcranial direct current stimulation (tDCS) for montages that involve extraencephalic electrodes. The methods provided by FSL and SPM12 are integrated into pipelines for the automatic generation of realistic head models based on tetrahedral meshes, which are distributed as part of the open-source software package SimNIBS for field calculations for transcranial brain stimulation.

Molecular and elemental effects underlying the biochemical action of transcranial direct current stimulation (tDCS) in appetite control

Recent studies highlight that obesity may alter the electric activity in brain areas triggering appetite and craving. Transcranial direct current brain stimulation (tDCS) has recently emerged as a safe alternative for treating food addiction via modulating cortical excitability without any high-risk surgical procedure to be utilized. As for anodal-type tDCS (atDCS), we observe increased excitability and spontaneous firing of the cortical neurons, whilst for the cathodal-type tDCS (ctDCS) a significant decrease is induced. Unfortunately, for the method to be fully used in a clinical setting, its biochemical action mechanism must be precisely defined, although it is proposed that molecular remodelling processes play in concert with brain activity changes involving the ions of: Na, Cl, K and Ca. Herein, we proposed for the first time Fourier transform infrared (FTIR) and synchrotron X-ray fluorescence (SRXRF) microprobes for a combined molecular and elemental analysis in the brain areas implicated appetite control, upon experimental treatment by either atDCS or ctDCS. The study, although preliminary, shows that by stimulating the prefrontal cortex in the rats fed high-caloric nutrients, the feeding behavior can be significantly changed, resulting in significantly inhibited appetite. Both, atDCS and ctDCS produced significant molecular changes involving qualitative and structural properties of lipids, whereas atDCS was found with a somewhat more significant effect on protein secondary structure in all the brain areas investigated. Also, tDCS was reported to reduce surface masses of Na, Cl, K, and Ca in almost all brain areas investigated, although the atDCS deemed to have a stronger neuro-modulating effect. Taken together, one can report that tDCS is an effective treatment technique, and its action mechanism in the appetite control seems to involve a variety of lipid-, protein- and metal/non-metal-ion-driven biochemical changes, regardless the current polarization.

Reduction of implicit cognitive bias with cathodal tDCS to the left prefrontal cortex.

Implicit associations can interfere with cognitive operations and behavioral decisions without direct intention. Enhancement of neural activity with anodal transcranial direct current stimulation (tDCS) was proposed to reduce implicit associations by means of improved cognitive control. However, a targeted reduction of distractive implicit associations by inhibitory cathodal tDCS, recently shown in spatial-numerical associations, provides an interesting alternative approach to support goal-directed behavior with transcranial brain stimulation. To test this rationale with a sham-controlled cross-over design, a standardized Implicit Association Test (IAT) was performed by 24 healthy participants parallel to 1 mA cathodal or sham tDCS to the left prefrontal cortex. In this double-classification task, insect versus flower pictures and negative versus positive words are mapped together onto two shared response keys with crossed response assignments in separate blocks. Responses were faster when insect + negative and flower + positive stimuli required the same answer (IAT effect). Most critically, the IAT effect was reduced during cathodal tDCS as compared to sham stimulation. Thus, results are consistent with the proposed stimulation rationale, with previous observations, and complementary to previous studies using different tDCS configurations.

Combined brain Fe, Cu, Zn and neurometabolite analysis - a new methodology for unraveling the efficacy of transcranial direct current stimulation (tDCS) in appetite control.

Obesity is a chronic, multifactorial origin disease that has recently become one of the most frequent lifestyle disorders. Unfortunately, current obesity treatments seem to be ineffective. At present, transcranial direct current brain stimulation (tDCS) represents a promising novel treatment methodology that seems to be efficient, well-tolerated and safe for a patient. Unfortunately, the biochemical action of tDCS remains unknown, which prevents its widespread use in the clinical arena, although neurobiochemical changes in brain signaling and metal metabolism are frequently reported. Therefore, our research aimed at exploring the biochemical response to tDCS in situ, in the brain areas triggering feeding behavior in obese animals. The objective was to propose a novel neurochemical (serotoninergic and dopaminergic signaling) and trace metal analysis of Fe, Cu and Zn. In doing so, we used energy-dispersive X-ray fluorescence (EDXRF) and high-performance liquid chromatography (HPLC). Anodal-type stimulation (atDCS) of the right frontal cortex was utilized to down-regulate food intake and body weight gain in obese rats. EDXRF was coupled with the external standard method in order to quantify the chemical elements within appetite-triggering brain areas. Major dopamine metabolites were assessed in the brains, based on the HPLC assay utilizing the external standard assay. Our study confirms that elemental analysis by EDXRF and brain metabolite assay by HPLC can be considered as a useful tool for the in situ investigation of the interplay between neurochemical and Fe/Cu/Zn metabolism in the brain upon atDCS. With this methodology, an increase in both Cu and Zn in the satiety center of the stimulated group could be reported. In turn, the most significant neurochemical changes involved dopaminergic and serotoninergic signaling in the brain reward system.

Investigate the effect of HD-tDCS on the prefrontal cortex using fNIRS for neurorehabilitation

Investigate the effect of HD-tDCS on the prefrontal cortex using fNIRS for neurorehabilitation

Augmentation of Everyday Problem Solving Abilities Using Transcranial Electric Stimulation

Augmentation of Everyday Problem Solving Abilities Using Transcranial Electric Stimulation

Human in-vivo brain magnetic resonance current density imaging (MRCDI)

Magnetic resonance current density imaging (MRCDI) and MR electrical impedance tomography (MREIT) are two emerging modalities, which combine weak time-varying currents injected via surface electrodes with magnetic resonance imaging (MRI) to acquire information about the current flow and ohmic conductivity distribution at high spatial resolution. The injected current flow creates a magnetic field in the head, and the component of the induced magnetic field ΔBz,c parallel to the main scanner field causes small shifts in the precession frequency of the magnetization. The measured MRI signal is modulated by these shifts, allowing to determine ΔBz,c for the reconstruction of the current flow and ohmic conductivity.Here, we demonstrate reliable ΔBz,c measurements in-vivo in the human brain based on multi-echo spin echo (MESE) and steady-state free precession free induction decay (SSFP-FID) sequences. In a series of experiments, we optimize their robustness for in-vivo measurements while maintaining a good sensitivity to the current-induced fields. We validate both methods by assessing the linearity of the measured ΔBz,c with respect to the current strength. For the more efficient SSFP-FID measurements, we demonstrate a strong influence of magnetic stray fields on the ΔBz,c images, caused by non-ideal paths of the electrode cables, and validate a correction method. Finally, we perform measurements with two different current injection profiles in five subjects. We demonstrate reliable recordings of ΔBz,c fields as weak as 1 nT, caused by currents of 1 mA strength. Comparison of the ΔBz,c measurements with simulated ΔBz,c images based on FEM calculations and individualized head models reveals significant linear correlations in all subjects, but only for the stray field-corrected data. As final step, we reconstruct current density distributions from the measured and simulated ΔBz,c data. Reconstructions from non-corrected ΔBz,c measurements systematically overestimate the current densities. Comparing the current densities reconstructed from corrected ΔBz,c measurements and from simulated ΔBz,c images reveals an average coefficient of determination R2 of 71%. In addition, it shows that the simulations underestimated the current strength on average by 24%.Our results open up the possibility of using MRI to systematically validate and optimize numerical field simulations that play an important role in several neuroscience applications, such as transcranial brain stimulation, and electro- and magnetoencephalography.

Neuromodulation for the treatment of eating disorders and obesity.

Eating disorders and obesity adversely affect individuals both medically and psychologically, leading to reduced life expectancy and poor quality of life. While there exist a number of treatments for anorexia, morbid obesity and bulimia, many patients do not respond favorably to current behavioral, medical or bariatric surgical management. Neuromodulation has been postulated as a potential treatment for eating disorders and obesity. In particular, deep brain stimulation and transcranial non-invasive brain stimulation have been studied for these indications across a variety of brain targets. Here, we review the neurobiology behind eating and eating disorders as well as the current status of preclinical and clinical neuromodulation trials for eating disorders and obesity.